Training in ENT; a comprehensive review of existing evidence

Rhinology Online. Published online July 25th, 2018 . DOI: 10.4193/RHINOL/18.027

Pavol Šurda, Aleksandra Barac, Puya Mobaraki Deghani, Thomas Jacques, Cristobal Langdon, João Pimentel, Alexander G. Mathioudakis, Peter Valentin Tomazic.

Despite an expansion of fellowship opportunities over the last three decades, there is still incomplete regulation and standardisation of fellowship training. The aim of this comprehensive review was to examine existing evidence about the ear, nose and throat (ENT) training, especially focused on surgical and non-surgical aspects of the training. It is challenging to critically evaluate and compare training programmes across nations for several reasons. Studies on the subject rely entirely on trainee self-reports, without any objective comparators between groups. No evidence exists that directly compares the theoretical or practical attainment of trainees between nations. More fundamentally, trainee exposure to, and competence in, elective surgical procedures, is not the sole measure of a training programme, nor can it be viewed in isolation from the health system’s expectations of a newlyqualified specialist, which may vary. During recent years, the Internet and e-learning methods were implemented into the training curriculum. Also, there is an increasing number of platforms that can host the ENT learning content free of charge. Novel educational tools are powerful alternative to standard teaching techniques within otorhinolaryngology education for both residents and medical students. Overall evidence for virtual reality (VR) simulators could be implemented as adjunct in training programs but cannot replace conventional methods. This is mainly due to the fact that actual surgical outcomes after VR training have not been studied so far, but may be the content of future larger scale studies. The otolaryngologists’ non-surgical training needs to extend beyond the limits of ENT as skills and experience in areas of ENT, respiratory medicine, allergology, infectious diseases, radiology and oncology are required in the diagnosis and management of ENT diseases.